Scared Off Of Calcium?

Don’t Be.

By Michael Roizen, M.D., And Mehmet Oz, M.D.

Shake, rattle … and stall. If you’ve suddenly found yourself staring at your bottle of calcium pills — not sure whether to shake one out or skip it — you’re not alone in feeling rattled. A new study (getting almost as much press as Chelsea Clinton’s wedding) claims that calcium tablets raise your heart-attack risk and are a dud at safeguarding your skeleton. What gives? Is calcium really dangerous? Useless? Both? Here’s why we YOU Docs think this supplement is still safe and essential, when you take it with the right stuff. (Clue: Make sure yours comes with vitamin D-3 and magnesium.)

Let’s start with the facts. First, the researchers didn’t actually give people calcium and check their hearts. Instead, they analyzed 11 older calcium studies, none focusing on heart attacks. You can infer interesting things this way; they’re just not always conclusive. Yup, 30 percent more heart attacks occurred in people over age 40 who took calcium pills. But while that sounds pretty big, in an analysis like this, it’s not. Even the researchers called it only a “modest” difference.

Second, the findings plainly don’t jibe with most other research. Plenty of other studies have found that calcium (from food or supplements) doesn’t up heart-health risk factors, like raising blood pressure or building up plaque in your arteries.

Third, there weren’t any extra heart attack-related deaths. Not that we wanted any! It’s just that if there are extra heart attacks, you’d expect a few extra deaths. Maybe, as a British Medical Journal editorial about the study suggested, the extra heart attacks were misdiagnoses -say, people who were logged into emergency rooms with “heart attack symptoms” but turned out to have severe digestive distress (it happens).

Fourth, about those missing bone benefits: This one’s easy. The analysis included only studies where calcium supplements were taken alone. It excluded people who also took vitamin D, which is essential for calcium absorption. Without D (especially D-3, the best form), there’s almost no way your body can absorb enough calcium to protect your skeleton.

That’s why we say: Don’t toss your calcium pills into the round receptacle based on this analysis. There’s strong evidence that calcium is vital for bones and little proof of heart-attack risk. Besides, calcium-rich foods (like low-fat dairy products) help your heart by keeping a lid on high blood pressure. For now, just do calcium right:

Take calcium with the right stuff: vitamin D-3 and magnesium. You need 1,000 IU of D-3 (1,200 IU after age 60) for maximum calcium absorption (and many other reasons: this formidable vitamin helps fight osteoarthritis, inflammation, some cancers, plus it helps regulate blood pressure).

You also need 400 to 500 mg of magnesium. Why? Because it keeps calcium from making you constipated, and because if there actually are any cardio risks from calcium (including internal spasms), magnesium relaxes the blood vessels and probably counters ‘em. Tip: Some handy-dandy combo pills contain all three nutrients; for what we recommend, see “Dr. Roizen’s Fab Five” at the Cleveland Clinic’s wellness site, www.360-5.com (we get no money for this).

Aim for 1,200 mg of calcium a day — and get as much as you can from food. Sip a glass of skim milk (300 mg), spoon up a cup of plain, low-fat no-sugar-added yogurt (415 mg) or sprinkle your salad with low-fat cheese (200 mg for a quarter-cup). Not into milk products? Have a cup of calcium-fortified soy milk or OJ (300 mg each), or a cup of cooked spinach (290 mg), a tin of sardines (370 mg in 3.5 ounces) or canned salmon (181 mg in 3 ounces). Some mineral waters have up to 108 mg per cup. Check labels. Broccoli, kale, even Chinese cabbage contribute, too.

Use calcium supplements to fill the gaps. While it’s pretty easy to get a few hundred milligrams a day from food, it’s hard to get all 1,200. So most people — including us — need to take calcium plus you-know-what-else. Go for calcium citrate, by the way; it’s well absorbed, whether or not you have it with a meal.

Spread it out. Your body can’t absorb more than 500 to 600 mg of calcium at a time, whether it’s in food or supplements, so space it throughout the day. Once you’ve worked this vitamin-mineral trio (D, magnesium and calcium) into your routine, your bones will be singing a happy tune, and, we suspect, so will your heart.

The YOU Docs, Mehmet Oz and MikeRoizen, are authors of “YOU: On a Diet.” Want more? See “The Dr. Oz Show” on TV (check local listings). To submit questions, go to www.RealAge.com.